Risk analysis in bariatric surgery: Impact of disease burden

Abstract

with liver histopathology. Methods: Routine core liver biopsy was simultaneously performed on 143 (13 (9%) males and 130 (91%) females) patients at the time of Roux-en-Y gastric bypass at UC Davis. Mean BMI was 46.9 5.8 kg/m, and mean age was 43.5 8.9 years. Twenty-two patients (15.4%) of the 143 were diabetic. Routine LFTs were obtained on all patients preoperatively. Liver specimens were histologically evaluated for the presence of NASH. Results: Of the 143 patients, 56 (39.1%) were positive for NASH as confirmed by liver biopsy. Only 4 patients (2.7%) overall had elevated LFTs. All patients with elevated LFTs exhibited NASH on liver biopsy. In contrast, only 4 (7.1%) of the 56 patients, with biopsy-proven NASH, had elevated LFTs preoperatively. Seven (31.8%) of the 22 diabetic patients had NASH on liver biopsy, and only 7 (12.5%) of the 56 patients with NASH were diabetic. Conclusions: While abnormalities in LFTs may be associated with NASH, our findings indicate that NASH is more prevalent, in the morbidly obese, than can be deduced by changes in LFTs alone. Additionally, the presence of diabetes mellitus seems to be only loosely associated with NASH. PII: S1550-7289(05)00222-4